LEUKEMIAS

This review addresses the basics of CAR T-cell design and reviews data from published clinical studies in leukemia.

According to findings from a phase II study released by Amgen, monotherapy with blinatumomab (Blincyto) showed promising complete remission (CR) or CR with partial hematological recovery (CRh) rates in adult patients with relapsed or refractory Philadelphia chromosome-positive (Ph+) B cell precursor acute lymphoblastic leukemia (ALL).

CPX-351 demonstrated a complete response (CR) or CR with incomplete hematologic recovery rate of 47.7% in elderly patients with untreated secondary acute myeloid leukemia.

Treatment with the combination of idelalisib and ofatumumab demonstrated an improvement in objective response rates, progression-free survival, and lymph node response compared with ofatumumab alone in patients with previously treated chronic lymphocytic leukemia.

Treatment with ibrutinib plus the anti-CD20 antibody ublituximab was shown to be safe with an objective response rate of 95% in patients with chronic lymphocytic leukemia.

Treatment with inotuzumab ozogamicin was found to be safe and effective in a phase III study for patients with relapsed or refractory acute lymphoblastic leukemia.

The IDH2 inhibitor AG-221 has demonstrated promising response rates in patients with acute myeloid leukemia and other hematologic malignancies.

The combination of ibrutinib with bendamustin plus rituximab (BR) demonstrated a significant improvement in progression-free survival compared with BR alone in patients with pretreated chronic lymphocytic leukemia or small lymphocytic lymphoma.

Treatment with the BTK inhibitor ibrutinib could enhance the efficacy of chemoimmunotherapy without increasing toxicity for patients with chronic lymphocytic leukemia.

Venetoclax (GDC-0199/ABT-199), a Bcl-2 inhibitor, has been granted a breakthrough therapy designation by the FDA for the treatment of patients with relapsed/refractory chronic lymphocytic leukemia. The designation is specific to those patients who harbor a 17p deletion (del[17p]).

Topline findings from the phase III COMPLEMENT 2 study indicated that treatment with ofatumumab (Arzerra) plus fludarabine and cyclophosphamide significantly improved progression-free survival (PFS) compared with fludarabine and cyclophosphamide alone in patients with relapsed chronic lymphocytic leukemia (CLL).

The chimeric antigen receptor (CAR) T-cell therapy JCAR017 elicited a 91% complete remission rate in pediatric patients with relapsed/refractory acute lymphoblastic leukemia (ALL).

Progression on treatment with ibrutinib in patients with chronic lymphocytic leukemia (CLL) was associated with pretreatment BCL6 abnormalities, acquired mutations in BTK and PLCG2, and complex karyotypes.

Combination therapy with ibrutinib plus bendamustine and rituximab significantly extended progression-free survival compared with BR alone in patients with chronic lymphocytic leukemia or small lymphocytic lymphoma enrolled in the phase III HELIOS trial.

Cytogenetic and molecular data are becoming increasingly important in the individualization of treatment of patients with acute myeloid leukemia (AML).

Experts on hematologic malignancies will convene for the 19th Annual International Congress on Hematologic Malignancies, from February 20-21 in Miami, Florida, to provide insight into recent developments in the treatment of the diseases.

Ibrutinib (Imbruvica) showed promising activity in heavily pretreated, relapsed/refractory chronic lymphocytic leukemia (CLL) after allogeneic stem cell transplantation (ASCT).

The FDA has granted a Fast Track Designation to CPX-351, a liposomal formulation of cytarabine and daunorubicin, for the treatment of elderly patients with relapsed acute myeloid leukemia (AML).

ASCO named the improved outlook for patients with chronic lymphocytic leukemia (CLL) as its inaugural “Cancer Advance of the Year.”

Jae Park, MD, assistant attending physician, Memorial Sloan Kettering Cancer Center, discusses CAR T-cell therapy for the treatment of acute lymphoblastic leukemia.

Treatment with nilotinib (Tasigna) in combination with chemotherapy elicited complete hematological remissions (CHR) in 87% of elderly patients with newly diagnosed Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL).

The anti-CD19 chimeric antigen receptor (CAR)-modified T-cell therapy CTL019 demonstrated a 92% complete response (CR) rate in pediatric patients with relapsed/refractory acute lymphoblastic leukemia (ALL).

The anti-CD19 immunotherapy blinatumomab (Blincyto) has been approved by the FDA as a treatment for patients with Philadelphia chromosome-negative relapsed/refractory B-precursor acute lymphoblastic leukemia (ALL), based on findings from a phase II trial.

Marcel R.M. van den Brink, MD, PhD, Head, Division of Hematologic Oncology, Memorial Sloan Kettering Cancer Center, discusses two abstracts being presented at ASH looking at CAR T cell therapies for the treatment of ALL and NHL.

The FDA has granted the chimeric antigen receptor (CAR) T cell therapy JCAR015 a breakthrough therapy designation as a treatment for patients with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL).